沈 暑必挟湿。伤在气分。古称滞下。此滞字。非停滞饮食。言暑湿内侵。腑中流行阻遏。而为滞
矣。消导。升举。温补。暑邪无有出路。胸痞不饥。不食。粘腻未已。而肛门沉坠里结。三焦皆受邪
蒸。上下浑如两截。延为休息痢疾。缠绵展转。岂旦晚骤愈之病。（暑湿热）
淡干姜 生姜 小川连 淡黄芩 人参 枳实
徐 夏季痢症。多是湿热食积。初起宜分消其邪。但肌柔白嫩。乃气虚之质。且性情畏药。只宜
少与勿过。
槟榔汁 青皮 陈皮 浓朴 川连 黄芩 木香 炒黑山楂
又 湿热下痢。必用苦辛寒为治。粟壳涩肠止泻。久痢成方。当此热邪未清。宣通。斯滞可去。因
色白气弱。未敢峻攻耳。
浓朴 黄芩 川连 木香汁 楂肉 炒银花
麦芽
卢 痢症湿热。皆是夏令伏邪。但以攻消。大伤胃气。不能去病。今微呕。不饥不寐。大便欲解不
通。是九窍六腑不和。总是胃病。
人参（一钱） 吴萸炒川连（四分） 泡淡生干姜（五分） 茯苓（三钱） 川楝子肉（一钱）
生白芍（一钱半）
某（女） 舌色灰黄。渴不多饮。不饥恶心。下利红白积滞。小溲不利此。暑湿内伏。三焦气机不主宣
达。宜用分理气血。不必见积。以攻涤下药。
飞滑石 川通草 猪苓 茯苓皮 藿香梗 浓朴 白蔻仁 新会皮
陆（氏） 经来暑秽痧胀。心烦自利黑瘀。
淡黄芩 枳实 川连 石菖蒲 郁金 橘红
陈（妪） 泻痢两月。肢体浮肿。高年自属虚象。但胸脘痞闷。纳谷恶心。每利必先腹痛。是夏秋暑热。
郁滞于中。虚体挟邪。焉有补涩可去邪扶正之理。恐交节令变症。明是棘手重症矣。
人参 茯苓 川连 淡干姜 生白芍 枳实
某 脐上青筋突痛。太阴脾受伤。此前症也。近日腹痛白积。两旬不已。是新受夏秋暑湿。与病
异岐。先理新病。导气分消主之。
藿香 浓朴 广皮 茯苓皮 川连 木香 木瓜 扁豆
某 痰哮宿病。正在初秋而发。又值寒热下痢血积。腹痛吐逆。脉来右弦左弱。目黄羞明。必是
暑湿凝滞着里。以补虚之中。佐以清邪。乃通剂法。
人参 黄 白芍 广皮 石莲子 川连 楂肉 草决明 金银花
王 痢疾古称滞下。乃是湿热气薄肠胃。阻闭气分。故利仍不爽。河间丹溪。佥用清热导气者
为此。（湿热）
黄芩 川连 草决明 炒黑楂肉 生白芍 石莲 丹皮 广木香汁
倪（六十） 面垢舌白。心下脘中。凄凄痛窒。至圊复便不爽。此水谷之湿。内蒸为热。气道阻闭。
上热下冷。若外受客邪。既过募原。必有寒热矣。
淡黄芩 川连 淡竹叶 槟榔汁 白芍 浓朴 广皮白
某 湿温下痢。脱肛。五苓散加寒水石。
江 食物不调。肠胃蕴蓄。郁蒸积聚而滞下。三月不愈清疏带补之。
人参 川连 炒白芍 炒楂肉 广皮 茯苓 炒当归 乌梅
陆 湿热内蕴。中焦痞结。阳气素虚体质。湿注自利不爽。神识昏乱。将变柔痉。
炒半夏 人参 枳实 川连 干姜 黄芩 姜汁
顾 得汤饮。腹中漉漉。自利稀水。平昔酒客留湿。湿胜内蕴。肠胃不爽。凝积。东垣清暑益气。亦
为湿热伤气而设。但脾胃久病。仍能纳食。当苦味坚阴。芳香理脾。
生茅术（四两） 炒黑黄柏（二两） 炒黑地榆（二两） 猪苓（一两半） 泽泻（一两半） 水法丸。服三钱。
葛（四十） 酒客。大便久泻。胁上曾发痈疡。春夏胁下有形。腹形满胀。此久蕴湿热。痈脓自利。未能泄
邪。肠胃气壅。利频不爽。法当分消以去湿热。若攻劫太过。必伤脾胃。议用丹溪小温中丸。早
进二钱五分。夜进二钱五分。三两。
某 潮热。自利。腹痛。
黄芩 生白芍 枳实 桔梗 槟榔汁 木香汁
徐 能食。腹痛。下痢。兼和其阴。
人参 生白芍 黄芩 枳实 川连 干姜
某（十六） 湿热内蒸下利红积。
炒黑神曲 炒黑楂肉 茯苓皮 飞滑石 新会皮 浓朴 淡竹叶 扁豆叶
祝（三八） 十年久痢。须推饮食避忌。酒客湿滞肠中。非风药之辛。佐苦味入肠。何以胜湿逐热。久病
饮食不减。肠中病也。
绵茵陈 香白芷 北秦皮 茯苓皮 黄柏 藿香
某 形瘦阴亏。湿热下痢。误投消食。反劫津液。邪未尽。津先耗。咽喉痛。且呛咳。所谓湿未罢。已
上燥矣。
川连 银花 通草 黄芩 川贝 茯苓皮
某 湿热内阻气分。腹痛下痢。目 黄。舌光不渴。议清里泄湿热。
黄芩 寒水石 川连 浓朴 秦皮 郁金
山（五十） 湿郁腹痛。利红如豆汁。
生茅术（三钱） 炒山楂（一钱半） 浓朴（一钱） 红曲（一钱半） 广皮（一钱） 猪苓（一钱）
某 夏秋痢疾。固是湿热伤气。脾胃气滞。后重里急不爽。古方香连丸。取其清里热。必佐理气。
谓气行斯湿热积聚无容留矣。知母生地。滋阴除热。治阴分阳亢之火。与痢门湿热大异。盖
滋则呆滞。气钝窒塞。宜乎欲便不出。究竟湿热留邪仍在。桂附热燥。又致肛坠。痛如刀割。补
中益气东垣成法。仅仅升举下焦清阳。未能直透肠中。再用大黄重药。兼知母生地等味。更
令伤及下焦。书义谓诸痢久。都属肾伤。小腹痛坠。忌冷。显然是下症。议与升阳。亦须下治。
人参 茯苓 泽泻 炙草 防风根 羌活 独活 细辛 生姜 大枣
某 舌白。渴不欲饮。心腹热。每痢必痛。肛坠。痢又不爽。微呕有痰。口味有变。头中空痛。两颊皆
赤。此水谷气蒸湿热。郁于肠胃。清浊交混。忽加烦躁难鸣苦况。法当苦寒泄热。苦辛香流气
渗泄利湿。盖积滞有形。湿与热本无形质耳。
川连 黄芩 郁金 浓朴 猪苓 槐米 秦皮
包 先厥。下利脓血。腹痛呕恶。乃寒热互伤。（厥阴伏热）
淡黄芩 川连 丹皮 生芍 炮姜 炒银花
陈（氏） 温邪经旬不解。发热自利。神识有时不清。此邪伏厥阴。恐致变痉。
白头翁 川连 黄芩 北秦皮 黄柏 生白芍
又 温邪误表。劫津。神昏。恐致痉厥。
炒生地 阿胶 炒麦冬 生白芍 炒丹皮 女贞子
邱（妪） 进润剂。痛缓积稀。知厥阴下利。宜柔宜通。血虚有风显然。
生地 阿胶 丹皮 生白芍 银花 小黑 豆皮
某 热渐入里。胸痞便泄。议酸苦泄热。
黄芩 川连 枳实 白芍 广皮白 滑石 甘草 谷芽
蔡 内虚邪陷。协热自利。脉左小右大。病九日不减。是为重症。议用白头翁汤方。加黄芩白
芍。（协热痢）
潘 时令暑湿。都从口鼻而受。气郁则营卫失于转运。必身热无汗。其邪自上以及中。必循募
原。致肠胃亦郁。腹痛泻积。无非湿热之化。此分消利湿则可。若以表药。则伤阳气矣。
茯苓 陈皮 浓朴 木香 炒扁豆 炒山楂
又 协热下利。粘腻血水。是肠胃中湿热之化也。
北秦皮 白头翁 茯苓 泽泻 炒银花 益元散
某 春温内陷下痢。最易厥脱。
川连 阿胶 淡黄芩 炒生地 生白芍 炙草
王 热毒逗留不化。潮热下利。
川连 黄芩 炒白芍 茯苓 泽泻 木瓜
张（三三） 江南地薄气弱。夏季食物内蕴。时令热迫内聚。湿热赤痢。入冬不愈。皆饮食不忌之累。宜
淡薄滋味。（血痢）
生茅术 浓朴 南山楂 草果仁 樗根皮 槐花 广皮 银花
又 痢血三月。昼痢夜止。肛门欲坠。以气陷门户不藏。
人参 当归 白芍 肉桂 炙草 白术 广皮 煨姜 南枣
某（二四） 血痢半载。少腹痛。六味地黄加炒楂肉炒延胡。
某 血积痛痢。起于夏令。秋半不减。明是湿热滞于肠胃。久延。面色消夺。右脉搏大。乃痢症所
大忌。稍通积聚。兼以和血。
酒炒大黄 川连 黄芩 丹皮 肉桂 归身 白芍 生甘草
袁（二七） 久痢。腹疼。下血。
生黄 （三钱） 生白术（三钱） 炒归身（一钱） 炒楂肉（二钱） 炒地榆（一钱半） 广皮（一钱）
浓朴（一钱） 羌活（五分） 防风根（五分）
朱（三九） 下痢带瘀血。肛中气坠。腹不痛。
炒黑樗根皮（一两） 生茅术（一钱） 生黄柏（一钱） 炒黑楂肉（三钱） 炒黑地榆（一钱半）
炒焦银花（一钱半） 赤苓（三钱） 猪苓（一钱半）
某 痛痢不爽。已有血下。暑湿不独在气分。且积劳茹素。攻夺宜慎。
当归 白芍 南山楂 浓朴 草果 炮姜
某 脉缓。脐上痛。便稀溺短。此乃湿郁脾胃之阳。致气滞里急。宗古人导湿分消意。（阳虚气滞）
生茅术 广皮 浓朴 官桂 飞滑石 茯苓 猪苓 泽泻 炒山楂
张（五七） 脉沉伏。久痢腹痛。畏寒少食。气弱肠滞。以温通方法。
熟附子 生茅术 生大黄 茯苓 浓朴 木香
又 温下相投。肠滞不通。皆因腑阳微弱。古贤治痢。不离通涩二法。
当归 肉桂心 茯苓 浓朴 南山楂 生麦芽
王（六二） 平昔温补相投。是阳不足之体。闻患痢两月。不忌食物。脾胃滞壅。今加呕恶。夫六腑宜通。
治痢之法。非通即涩。肛肠结闭。阳虚者。以温药通之。
熟附子 制大黄 浓朴 木香 茯苓皮
范（二七） 痢称滞下。谓有滞必先痛后下。况病起不慎口腹。阳气窒塞。积聚留着。试阅前方。宣通者
有效。守补则病剧。六腑皆以宣通为用。
附子 大黄 茯苓 浓朴 生草果 广皮
又 温下已效。肠胃留滞。都因阳不主运。再佐理气兼之。
附子 制大黄 茯苓 广皮 浓朴 生益智 木香 猪苓
李 痢将两月。目微黄。舌白口干。唇燥赤。腹满。按之软。竟日小便不通。病者自述肛门窒塞。努
挣不已。仅得迸出粘积点滴。若有稀粪。自必倾肠而多。思夏秋间暑湿内着为痢。轩岐称曰
滞下。谓滞着气血。不独食滞一因。凡六腑属阳。以通为用。五脏皆阴。藏蓄为体。先泻后痢。脾
传肾则逆。即土克水意。然必究其何以传克之由。盖伏邪垢滞从中不清。因而下注矣。迁延
日久。正气因虚。仲景论列三阴。至太阴篇中。始挈出腹满字样。脾为柔脏。惟刚药可以宣阳
驱浊。但今二肠窒痹。气不流行。理中等法。决难通腑。考内经二虚一实者治其实。开其一面
也。然必温其阳。佐以导气逐滞。欲图扭转机关。舍此更无他法。
制附子 生浓朴 木香 制大黄 炒黑大茴
又 懈弛半月。脾肾复惫。脾败不主健运。纳食皆变痰沫。肾真失司纳气。水液上泛阻咽。皆痢
伤浊壅。变胀末传。脉见弦劲。是无胃气。小愈变病。最属不宜。入冬为藏阳之令。今阳渐溃散。
而阴液枯槁。渴不多饮。饮不解渴。治阳必用刚药。其阴更涸矣。转展无可借箸。勉与脾肾分
调。脾阳动则冀运。肾阳静可望藏。王道固难速功。揆之体用。不可险药。
早服炒焦肾气丸 午服参苓白术散加益智仁。
许（三三） 劳倦咳嗽失血。仍然不避寒暑。食物腹中泻痢。病上加病。后感。法当先治。以分病
有新旧。（阳虚）
浓朴 益智 广皮 茯苓皮 白芍 炙草 木瓜 炒扁豆
又 咳嗽泻痢。药治相背。治肺碍脾。治脾碍肺。方今交冬。治痢为要。病患说早食相安。晚食胀
满。脾胃阳气已乏。勿徒消滞寒克矣。
白芍（桂酒拌） 益智 广皮 茯苓 焦白术 炙草 谷芽 砂仁壳
张 下痢泄泻之后。诊脉右弦大。胃虚少纳。阳弱不司运化。法当通腑之阳。
人参 益智仁 炒菟丝饼 炒砂仁末 茯苓 广皮白
陆（二六） 腹满自痢。脉来濡小。病在太阴。况小便清长。非腑病湿热之比。法当温之。
生于术 附子 茯苓 浓朴 干姜
许（二四） 痢疾一年。已浮肿溺涩。古称久痢必伤肾。月前用理阴煎不应。询及食粥吞酸。色瘁脉濡。
中焦之阳日惫。水谷之湿不运。仍辛温以苏脾阳。佐以分利。用胃苓汤。去甘草加益智。
陈 痢积虽然少缓。诸款不减。面色青晦。四肢厥冷。仍在险途。拟进益黄散法。
人参 煨益智仁 公丁香 茯苓 广皮 青皮 木瓜 炒冬米
某 脉微细。肢厥。下痢无度。吴茱萸汤。但能止痛。仍不进食。此阳败阴浊。腑气欲绝。用桃花汤。
赤石脂 干姜 白粳米
某 痢后大便不实。食不健运。色脉俱是虚象。此清阳失旷于中。阴气先走泄于下。先理中焦。
再当摄阴。
人参 白术 茯苓 炙草 广皮 炮姜 益智
某 自利不渴者属太阴。呃忒之来。由乎胃少纳谷。冲气上逆。有土败之象。势已险笃。议金匮
附子粳米汤。
人参 附子 干姜 炙草 粳米
某 长斋有年。土薄气馁。加以久痢少谷欲呕。脾胃之阳衰矣。由夏及今。半载不痊。倘忽肿胀。
何法施治。
人参 白术 干姜 炮姜 丁香 茯苓
袁 中下阳微。呕呃下利。温中不应。恐延衰脱。夫阳宜通。阴宜守。此关闸不致溃散。春回寒谷。
生气有以把握。候王先生主议。
人参 附子 炮姜 炒粳米 赤石脂 生白芍
沈 暑邪必定挟带湿邪。病位伤在气分。古人称之为“滞下”。这个“滞”字，并非指饮食停滞，而是指暑湿内侵，导致腑中气机流行受阻遏，从而形成“滞”的状态。若使用消食导滞、升提举陷或温补的方法，暑邪便没有出路。患者出现胸脘痞闷、不知饥饿、不能进食，粘腻之象未除，且肛门沉重下坠、里急后重。这是三焦都受到邪热熏蒸，上下仿佛隔绝为两截。拖延下去会演变为休息痢疾，缠绵反复，这岂是早晚就能突然痊愈的病？（证属：暑湿热）
淡干姜、生姜、小川连、淡黄芩、人参、枳实
徐 夏季的痢症，多是湿热与食积互结。初起时应当分消其邪。但该患者肌肤柔嫩白皙，属于气虚体质。且性情畏药，只宜少量给药，不可过量。
槟榔汁、青皮、陈皮、厚朴、川连、黄芩、木香、炒黑山楂
又诊 湿热下痢，必须用苦辛寒的药物来治疗。罂粟壳能涩肠止泻，是治疗久痢的成方。但此时热邪尚未清除，应当宣通气机，这样积滞才可去除。因为患者面色白、气息弱，所以不敢使用峻猛的攻下药。
厚朴、黄芩、川连、木香汁、楂肉、炒银花、麦芽
卢 痢症的湿热，都是夏令潜伏的邪气。如果只用攻伐消导，会大伤胃气，反而不能去病。现在患者轻微呕吐、不知饥饿、无法入睡，大便想解却不通畅，这是九窍六腑不和，总归是胃病。
人参（一钱）、吴茱萸炒川连（四分）、泡淡生干姜（五分）、茯苓（三钱）、川楝子肉（一钱）、生白芍（一钱半）
某（女） 舌色灰黄，口渴但不多饮，不知饥饿且恶心，下利红白黏液，小便不利。这是暑湿内伏，三焦气机不能宣达。应当用分理气血的方法，不必一见有积滞就用攻涤的下药。
飞滑石、川通草、猪苓、茯苓皮、藿香梗、厚朴、白蔻仁、新会皮
陆（氏） 经期遇到暑秽之气引发痧胀，心烦，自利黑色瘀血。
淡黄芩、枳实、川连、石菖蒲、郁金、橘红
陈（妪） 腹泻痢疾两个月，肢体浮肿。高龄之人自然属于虚象。但胸脘痞闷，纳谷恶心，每次排便前必先腹痛，这是夏秋暑热郁滞于中焦。虚体夹杂邪气，哪有通过补益固涩来祛邪扶正的道理？恐怕交节令时会发生变症，明明白白是棘手重症。
人参、茯苓、川连、淡干姜、生白芍、枳实
某 脐上青筋突起疼痛，这是太阴脾受伤，是之前的病症。近日腹痛伴有白色黏液，持续二十天不好，这是新近感受夏秋暑湿，与旧病不同。先调理新病，用导气分消的主方。
藿香、厚朴、广皮、茯苓皮、川连、木香、木瓜、扁豆
某 痰哮宿疾，正在初秋发作。又正值寒热交替、下痢血积，腹痛呕吐逆气，脉象右弦左弱，目黄羞明。必定是暑湿凝滞着于里。在补虚的同时，佐以清解邪气，这是通剂的治法。
人参、黄芪、白芍、广皮、石莲子、川连、楂肉、草决明、金银花
王 痢疾古称滞下，乃是湿热之气薄蚀肠胃，阻闭气分，所以虽然有利下但仍不爽快。刘河间、朱丹溪都用清热导气的方法，就是为此。（证属：湿热）
黄芩、川连、草决明、炒黑楂肉、生白芍、石莲、丹皮、广木香汁
倪（六十岁） 面部污垢，舌苔白，心下脘中凄凄作痛且有窒塞感，如厕后大便仍不爽快。这是水谷之湿，内蒸化为热，气道阻闭，上热下冷。如果外受客邪，既然已经过了募原，必然会有寒热往来。
淡黄芩、川连、淡竹叶、槟榔汁、白芍、厚朴、广皮白
江 食物不调，肠胃蕴蓄，郁蒸积聚而致滞下，三个月不愈。用清疏兼补的方法。
人参、川连、炒白芍、炒楂肉、广皮、茯苓、炒当归、乌梅
陆 湿热内蕴，中焦痞结。阳气素虚的体质，湿气下注导致自利不爽，神识昏乱，将要变成柔痉。
炒半夏、人参、枳实、川连、干姜、黄芩、姜汁
顾 喝汤饮后，腹中漉漉有声，自利稀水。平素是酒客，体内留有湿邪，湿胜内蕴，肠胃不爽，凝积。李东垣的清暑益气汤，也是为湿热伤气而设的。但脾胃久病，仍能纳食，应当用苦味坚阴，芳香理脾。
生茅术（四两）、炒黑黄柏（二两）、炒黑地榆（二两）、猪苓（一两半）、泽泻（一两半），水泛为丸，服三钱。
葛（四十岁） 酒客，大便久泻，胁上曾发痈疡，春夏季节胁下有形之物，腹部满胀。这是久蕴湿热，痈脓自利，未能泄出邪气，肠胃气壅，利频而不爽。治法应当分消以去湿热。如果攻劫太过，必伤脾胃。议用丹溪的小温中丸，早进二钱五分，晚进二钱五分，共三两。
某 潮热，自利，腹痛。
黄芩、生白芍、枳实、桔梗、槟榔汁、木香汁
徐 能食，腹痛，下痢。兼和其阴。
人参、生白芍、黄芩、枳实、川连、干姜
某（十六岁） 湿热内蒸下利红色黏液。
炒黑神曲、炒黑楂肉、茯苓皮、飞滑石、新会皮、厚朴、淡竹叶、扁豆叶
祝（三八岁） 十年久痢，必须推究饮食避忌。酒客湿滞肠中，不用风药的辛散，佐以苦味入肠，怎么能胜湿逐热？久病饮食不减，是肠中的病。
绵茵陈、香白芷、北秦皮、茯苓皮、黄柏、藿香
某 形体消瘦，阴亏，湿热下痢。误投消食药，反而劫夺津液。邪气未尽，津液先耗，咽喉痛，且呛咳。所谓湿邪未罢，已出现上燥。
川连、银花、通草、黄芩、川贝、茯苓皮
某 湿热内阻气分，腹痛下痢，目黄，舌光不渴。议清里泄湿热。
黄芩、寒水石、川连、厚朴、秦皮、郁金
山（五十岁） 湿郁腹痛，利下红色如豆汁。
生茅术（三钱）、炒山楂（一钱半）、厚朴（一钱）、红曲（一钱半）、广皮（一钱）、猪苓（一钱）
某 夏秋痢疾，固然是湿热伤气，脾胃气滞，后重里急不爽。古方香连丸，取其清里热，必须佐以理气药。谓气行则湿热积聚无容留之地。知母、生地滋阴除热，治的是阴分阳亢之火，与痢门湿热大异。盖滋腻则呆滞，气钝窒塞，理应欲便不出。究竟湿热留邪仍在。桂附热燥，又致肛坠，痛如刀割。补中益气是东垣成法，仅仅升举下焦清阳，未能直透肠中。再用大黄重药，兼知母生地等味，更令伤及下焦。书义谓诸痢久，都属肾伤，小腹痛坠，忌冷，显然是下焦症。议与升阳，亦须下治。
人参、茯苓、泽泻、炙草、防风根、羌活、独活、细辛、生姜、大枣
某 舌白，渴不欲饮，心腹热，每痢必痛，肛坠，痢又不爽，微呕有痰，口味有变，头中空痛，两颊皆赤。这是水谷气蒸湿热，郁于肠胃，清浊交混，忽加烦躁难鸣苦况。法当苦寒泄热，苦辛香流气渗泄利湿。盖积滞有形，湿与热本无形质耳。
川连、黄芩、郁金、厚朴、猪苓、槐米、秦皮
包 先厥逆，下利脓血，腹痛呕恶，乃寒热互伤。（证属：厥阴伏热）
淡黄芩、川连、丹皮、生芍、炮姜、炒银花
陈（氏） 温邪经旬不解，发热自利，神识有时不清。此邪伏厥阴，恐致变痉。
白头翁、川连、黄芩、北秦皮、黄柏、生白芍
又诊 温邪误用表药，劫夺津液，神昏，恐致痉厥。
炒生地、阿胶、炒麦冬、生白芍、炒丹皮、女贞子
邱（妪） 进润剂，痛缓积稀。知厥阴下利，宜柔宜通。血虚有风显然。
生地、阿胶、丹皮、生白芍、银花、小黑豆皮
某 热渐入里，胸痞便泄。议酸苦泄热。
黄芩、川连、枳实、白芍、广皮白、滑石、甘草、谷芽
蔡 内虚邪陷，协热自利，脉左小右大，病九日不减，是为重症。议用白头翁汤方，加黄芩白芍。（证属：协热痢）
潘 时令暑湿，都从口鼻而受。气郁则营卫失于转运，必身热无汗。其邪自上以及中，必循募原，致肠胃亦郁，腹痛泻积，无非湿热之化。此分消利湿则可。若以表药，则伤阳气矣。
茯苓、陈皮、厚朴、木香、炒扁豆、炒山楂
又诊 协热下利，粘腻血水，是肠胃中湿热之化也。
北秦皮、白头翁、茯苓、泽泻、炒银花、益元散
某 春温内陷下痢，最易厥脱。
川连、阿胶、淡黄芩、炒生地、生白芍、炙草
王 热毒逗留不化，潮热下利。
川连、黄芩、炒白芍、茯苓、泽泻、木瓜
张（三三岁） 江南地薄气弱，夏季食物内蕴，时令热迫内聚，湿热赤痢，入冬不愈，皆饮食不忌之累。宜淡薄滋味。（证属：血痢）
生茅术、厚朴、南山楂、草果仁、樗根皮、槐花、广皮、银花
又诊 痢血三月，昼痢夜止，肛门欲坠，以气陷门户不藏。
人参、当归、白芍、肉桂、炙草、白术、广皮、煨姜、南枣
某 血积痛痢，起于夏令，秋半不减，明是湿热滞于肠胃，久延，面色消夺，右脉搏大，乃痢症所大忌。稍通积聚，兼以和血。
酒炒大黄、川连、黄芩、丹皮、肉桂、归身、白芍、生甘草
袁（二七岁） 久痢，腹疼，下血。
生黄芪（三钱）、生白术（三钱）、炒归身（一钱）、炒楂肉（二钱）、炒地榆（一钱半）、广皮（一钱）、厚朴（一钱）、羌活（五分）、防风根（五分）
朱（三九岁） 下痢带瘀血，肛中气坠，腹不痛。
炒黑樗根皮（一两）、生茅术（一钱）、生黄柏（一钱）、炒黑楂肉（三钱）、炒黑地榆（一钱半）、炒焦银花（一钱半）、赤苓（三钱）、猪苓（一钱半）
某 痛痢不爽，已有血下。暑湿不独在气分，且积劳茹素，攻夺宜慎。
当归、白芍、南山楂、厚朴、草果、炮姜
某 脉缓，脐上痛，便稀溺短。此乃湿郁脾胃之阳，致气滞里急。宗古人导湿分消意。（证属：阳虚气滞）
生茅术、广皮、厚朴、官桂、飞滑石、茯苓、猪苓、泽泻、炒山楂
张（五七岁） 脉沉伏，久痢腹痛，畏寒少食，气弱肠滞。以温通方法。
熟附子、生茅术、生大黄、茯苓、厚朴、木香
又诊 温下相投，肠滞不通，皆因腑阳微弱。古贤治痢，不离通涩二法。
当归、肉桂心、茯苓、厚朴、南山楂、生麦芽
王（六二岁） 平昔温补相投，是阳不足之体。闻患痢两月，不忌食物，脾胃滞壅，今加呕恶。夫六腑宜通，治痢之法，非通即涩。肛肠结闭，阳虚者，以温药通之。
熟附子、制大黄、厚朴、木香、茯苓皮
范（二七岁） 痢称滞下，谓有滞必先痛后下。况病起不慎口腹，阳气窒塞，积聚留着。试阅前方，宣通者有效，守补则病剧。六腑皆以宣通为用。
附子、大黄、茯苓、厚朴、生草果、广皮
又诊 温下已效，肠胃留滞，都因阳不主运，再佐理气兼之。
附子、制大黄、茯苓、广皮、厚朴、生益智、木香、猪苓
李 痢将两月，目微黄，舌白口干，唇燥赤，腹满，按之软。竟日小便不通，病者自述肛门窒塞，努挣不已，仅得迸出粘积点滴。若有稀粪，自必倾肠而多。思夏秋间暑湿内着为痢，轩岐称曰滞下，谓滞着气血，不独食滞一因。凡六腑属阳，以通为用；五脏皆阴，藏蓄为体。先泻后痢，脾传肾则逆，即土克水意。然必究其何以传克之由。盖伏邪垢滞从中不清，因而下注矣。迁延日久，正气因虚。仲景论列三阴，至太阴篇中，始挈出腹满字样。脾为柔脏，惟刚药可以宣阳驱浊。但今二肠窒痹，气不流行，理中等法，决难通腑。考内经二虚一实者治其实，开其一面也。然必温其阳，佐以导气逐滞，欲图扭转机关，舍此更无他法。
制附子、生厚朴、木香、制大黄、炒黑大茴
又诊 懈弛半月，脾肾复惫，脾败不主健运，纳食皆变痰沫，肾真失司纳气，水液上泛阻咽，皆痢伤浊壅，变胀末传，脉见弦劲，是无胃气，小愈变病，最属不宜。入冬为藏阳之令，今阳渐溃散，而阴液枯槁，渴不多饮，饮不解渴，治阳必用刚药，其阴更涸矣。转展无可借箸。勉与脾肾分调，脾阳动则冀运，肾阳静可望藏。王道固难速功，揆之体用，不可险药。
早服炒焦肾气丸，午服参苓白术散加益智仁。
许（三三岁） 劳倦咳嗽失血，仍然不避寒暑，食物腹中泻痢，病上加病，后感，法当先治，以分病有新旧。（证属：阳虚）
厚朴、益智、广皮、茯苓皮、白芍、炙草、木瓜、炒扁豆
又诊 咳嗽泻痢，药治相背，治肺碍脾，治脾碍肺。方今交冬，治痢为要。病患说早食相安，晚食胀满，脾胃阳气已乏，勿徒消滞寒克矣。
白芍（桂酒拌）、益智、广皮、茯苓、焦白术、炙草、谷芽、砂仁壳
张 下痢泄泻之后，诊脉右弦大，胃虚少纳，阳弱不司运化。法当通腑之阳。
人参、益智仁、炒菟丝饼、炒砂仁末、茯苓、广皮白
陆（二六岁） 腹满自痢，脉来濡小，病在太阴。况小便清长，非腑病湿热之比。法当温之。
生于术、附子、茯苓、厚朴、干姜
许（二四岁） 痢疾一年，已浮肿溺涩。古称久痢必伤肾。月前用理阴煎不应。询及食粥吞酸，色瘁脉濡，中焦之阳日惫，水谷之湿不运。仍辛温以苏脾阳，佐以分利。用胃苓汤，去甘草加益智。
陈 痢积虽然少缓，诸款不减，面色青晦，四肢厥冷，仍在险途。拟进益黄散法。
人参、煨益智仁、公丁香、茯苓、广皮、青皮、木瓜、炒冬米
某 脉微细，肢厥，下痢无度。吴茱萸汤，但能止痛，仍不进食。此阳败阴浊，腑气欲绝。用桃花汤。
赤石脂、干姜、白粳米
某 痢后大便不实，食不健运，色脉俱是虚象。此清阳失旷于中，阴气先走泄于下。先理中焦，再当摄阴。
人参、白术、茯苓、炙草、广皮、炮姜、益智
某 自利不渴者属太阴。呃忒之来，由乎胃少纳谷，冲气上逆，有土败之象，势已险笃。议金匮附子粳米汤。
人参、附子、干姜、炙草、粳米
某 长斋有年，土薄气馁，加以久痢少谷欲呕，脾胃之阳衰矣。由夏及今，半载不痊。倘忽肿胀，何法施治。
人参、白术、干姜、炮姜、丁香、茯苓
袁 中下阳微，呕呃下利，温中不应，恐延衰脱。夫阳宜通，阴宜守，此关闸不致溃散，春回寒谷，生气有以把握。候王先生主议。
人参、附子、炮姜、炒粳米、赤石脂、生白芍
Shen: Summerheat must carry dampness. The injury is in the Qi level. Ancient texts call this "Zhi Xia" (Dysentery with obstruction). This character "Zhi" (obstruction/stagnation) does not refer to food stagnation, but indicates that summerheat and dampness invade internally, obstructing the circulation in the Fu organs, thereby forming a state of stagnation. If one uses methods of digestion/promotion, lifting/raising, or warming/tonifying, the summerheat pathogen will have no exit. The patient presents with chest and epigastric fullness, lack of appetite, inability to eat, persistent sticky sensation, heavy bearing down at the anus, and tenesmus. This indicates that the San Jiao (Triple Burner) is all affected by steaming pathogens, with the upper and lower parts seemingly separated into two distinct zones. Prolonged progression leads to intermittent dysentery, lingering and recurring. This is certainly not a disease that can be cured suddenly within a day or two. (Pattern: Summerheat-Damp-Heat)
Dried Ginger (light), Fresh Ginger, Coptis Rhizome (small), Scutellaria Root (light), Ginseng Radix et Rhizoma, Immature Bitter Orange
Xu: Summer dysentery cases are mostly due to Damp-Heat combined with Food Stagnation. In the initial stage, the pathogen should be dispersed and eliminated. However, the patient has soft, white, and tender skin, indicating a Qi-deficient constitution. Moreover, the patient fears medication; therefore, only small doses should be given, avoiding excess.
Betel Nut Juice, Green Tangerine Peel, Tangerine Peel, Magnolia Bark, Coptis Rhizome, Scutellaria Root, Aucklandia Root, Charred Hawthorn Fruit
Second visit: For Damp-Heat dysentery descending, bitter-pungent-cold herbs must be used. Poppy Shell astringes the intestines and stops diarrhea, which is a established prescription for chronic dysentery. However, since the Heat pathogen is not yet cleared, one should promote circulation/diffusion so that the stagnation can be removed. Because the patient's complexion is pale and Qi is weak, harsh purgatives dare not be used.
Magnolia Bark, Scutellaria Root, Coptis Rhizome, Aucklandia Root Juice, Hawthorn Flesh, Chrysanthemum Flower (stir-fried), Malt
Lu: The Damp-Heat in dysentery stems from latent pathogens from midsummer. If only attacking and resolving methods are used, it severely damages Stomach Qi, failing to eliminate the disease. Now the patient has slight vomiting, lack of appetite, and insomnia. The desire to defecate without passage indicates disharmony of the nine orifices and six Fu organs, ultimately rooted in Stomach disease.
Ginseng Radix et Rhizoma (1 qian), Coptis Rhizome stir-fried with Evodia Fruit (4 fen), Raw Dried Ginger soaked lightly (5 fen), Poria (3 qian), Toosendan Fruit Flesh (1 qian), Raw White Peony Root (1.5 qian)
Certain female patient: Tongue color is grayish-yellow, thirst with little drinking, lack of appetite with nausea, passing red and white sticky discharge, and difficult urination. This is Summerheat-Dampness latent internally, with the Qi mechanism of the San Jiao unable to diffuse and reach. One should use methods to differentiate and regulate Qi and Blood. There is no need to see accumulation and immediately use purgative drugs to scour it away.
Calcined Talcum, Tetrapanax Pith, Polyporus, Poria Cocos Skin, Agastache Stem, Magnolia Bark, Cardamom Seed, New Tangerine Peel
Lu (Family): During menstruation, Summerheat miasma caused Sha Syndrome (plague-like distension). Heart vexation, spontaneous passage of black bloody stasis.
Scutellaria Root (light), Immature Bitter Orange, Coptis Rhizome, Acorus Rhizome, Curcuma Tuber, Tangerine Red Peel
Chen (Elderly woman): Diarrhea and dysentery for two months, limb edema. Advanced age naturally implies deficiency. However, there is chest and epigastric fullness, poor appetite with nausea, and abdominal pain preceding each bowel movement. This is Summerheat-Heat from summer and autumn stagnating in the middle. A deficient body harboring pathogens—how can tonification and astringency remove pathogens and support righteousness? Fear of transformation upon solar term changes makes this clearly a tricky severe case.
Ginseng Radix et Rhizoma, Poria, Coptis Rhizome, Dried Ginger (light), Raw White Peony Root, Immature Bitter Orange
Certain patient: Blue veins protruding above the umbilicus with painful distension indicates injury to the Taiyin Spleen; this was the previous condition. Recently, abdominal pain with white discharge has persisted for twenty days. This is a new contraction of Summer-Dampness from summer and autumn, differing from the old disease. First treat the new disease using the main formula for guiding Qi and dispersing differentiation.
Patchouli Leaf, Magnolia Bark, Broadleaf Citrus Peel, Poria Cocos Skin, Coptis Rhizome, Aucklandia Root, Quince Fruit, Lablab Bean
Certain patient: Chronic Phlegm-Wheezing recurs in early autumn. Coinciding with alternating cold and fever, bloody dysentery, abdominal pain, and vomiting/regurgitation. Pulse is wiry on the right and weak on the left, yellow eyes with photophobia. This must be Summerheat-Dampness condensing and attaching to the interior. Within tonifying deficiency, assist with clearing pathogens; this is the method of unblocking agents.
Ginseng Radix et Rhizoma, Astragalus Root, White Peony Root, Broadleaf Citrus Peel, Stone Lotus Seed, Coptis Rhizome, Hawthorn Flesh, Cassia Seed, Honeysuckle Flower
Wang: Dysentery was anciently called "Zhi Xia" (Obstructive Downward Flow). It is Damp-Heat thinning/biting the stomach and intestines, blocking the Qi level, hence the passage is still unsatisfactory. He-Jian (Liu Wansu) and Dan-Xi (Zhu Zhenheng) both used clearing heat and guiding Qi methods for this reason. (Pattern: Damp-Heat)
Scutellaria Root, Coptis Rhizome, Cassia Seed, Charred Black Hawthorn Fruit, Raw White Peony Root, Stone Lotus Seed, Moutan Cortex, Broadleaf Aucklandia Root Juice
Ni (60 years old): Foul face, white tongue coating. Cold pain and stifling sensation below the heart and in the epigastrium. After defecation, stool remains unsatisfactory. This is dampness from water and grain steaming internally into heat, blocking the Qi pathway, resulting in upper heat and lower cold. If external pathogenic factors were received, having passed the Mu Yuan (Sea of Origin), there would surely be alternating chills and fever.
Scutellaria Root (light), Coptis Rhizome, Light Bamboo Leaf, Betel Nut Juice, White Peony Root, Magnolia Bark, Broadleaf Citrus Peel White
Certain patient: Damp-Warmth causing dysentery with rectal prolapse. Use Wu Ling San (Five-Ingredient Powder with Poria) plus Halloysitum Rubrum (Han Shui Shi).
Jiang: Improper diet causes accumulation in the stomach and intestines, steaming and gathering to form obstructive downward flow. Unresolved for three months. Use clearing and dispersing with tonification.
Ginseng Radix et Rhizoma, Coptis Rhizome, Stir-fried White Peony Root, Stir-fried Hawthorn Fruit, Broadleaf Citrus Peel, Poria, Stir-fried Angelica Sinensis, Chinese Plum
Lu: Damp-Heat accumulates internally, causing epigastric knotting. The constitution has inherent Yang deficiency. Dampness pouring downward causes unsatisfactory spontaneous diarrhea. Consciousness is confused, threatening to transform into Flaccid Spasm (Rou Jing).
Stir-fried Pinellia Tuber, Ginseng Radix et Rhizoma, Immature Bitter Orange, Coptis Rhizome, Dried Ginger, Scutellaria Root, Ginger Juice
Gu: After drinking soup/water, gurgling sounds in the abdomen, spontaneous passage of watery stool. As a habitual drinker, dampness remains internally. Excess dampness accumulates internally, causing gastrointestinal discomfort and coagulation/stagnation. Dong-Yuan's Qing Shu Yi Qi Tang (Clear Summerheat and Boost Qi Decoction) is also designed for Damp-Heat injuring Qi. However, with long-standing Spleen-Stomach disease, the ability to ingest food remains. One should use bitter flavors to firm Yin and aromatic herbs to regulate the Spleen.
Raw Atractylodes Macrocephala Rhizome (4 liang), Stir-fried Black Phellodendron Bark (2 liang), Stir-fried Black Sanguisorba Root (2 liang), Polyporus (1.5 liang), Alisma Rhizome (1.5 liang). Make pills with water, take 3 qian.
Ge (40 years old): Habitual drinker, chronic loose stools. Previously developed carbuncles on the hypochondrium. In spring and summer, palpable masses under the ribs, abdominal fullness/distension. This is long-standing accumulated Damp-Heat. Carbuncle pus passes spontaneously, failing to vent the pathogen. Gastrointestinal Qi is congested, frequent unsatisfactory passage. The method should be to disperse and eliminate to remove Damp-Heat. If purging is too excessive, Spleen and Stomach will be injured. Propose Dan-Xi's Xiao Wen Zhong Wan (Small Warming Middle Pill). Take 2.5 qian in the morning, 2.5 qian at night, total 3 liang.
Certain patient: Tidal fever, spontaneous diarrhea, abdominal pain.
Scutellaria Root, Raw White Peony Root, Immature Bitter Orange, Platycodon Root, Betel Nut Juice, Aucklandia Root Juice
Xu: Able to eat, abdominal pain, dysentery. Simultaneously harmonize Yin.
Ginseng Radix et Rhizoma, Raw White Peony Root, Scutellaria Root, Immature Bitter Orange, Coptis Rhizome, Dried Ginger
Certain patient (16 years old): Internal steaming of Damp-Heat causing red dysentery.
Stir-fried Black Medicated Leaven, Stir-fried Black Hawthorn Fruit, Poria Cocos Skin, Calcined Talcum, New Tangerine Peel, Magnolia Bark, Light Bamboo Leaf, Lablab Bean Leaf
Zhu (38 years old): Ten-year chronic dysentery. Must deduce dietary taboos. For drinkers, dampness stagnates in the intestines. Without the pungency of Wind-dispelling herbs assisted by bitter flavors entering the intestines, how can dampness be overcome and heat expelled? Long-term illness with unchanged diet indicates intestinal pathology.
Cottonworm Fern (Mian Yin Chen), Fragrant Angelica Root, Northern Birch Bark, Poria Cocos Skin, Phellodendron Bark, Patchouli Leaf
Certain patient: Emaciated with Yin deficiency, Damp-Heat dysentery. Mistakenly administered digestive aids, which instead seized fluids. Pathogens not fully cleared, fluids consumed first. Sore throat and choking cough. This means dampness has not ceased, yet upper dryness has appeared.
Coptis Rhizome, Honeysuckle Flower, Tetrapanax Pith, Scutellaria Root, Fritillaria Bulb, Poria Cocos Skin
Certain patient: Damp-Heat obstructing the Qi level internally, abdominal pain and dysentery, yellow eyes, glossy tongue without thirst. Propose clearing the interior and draining Damp-Heat.
Scutellaria Root, Halloysitum Rubrum, Coptis Rhizome, Magnolia Bark, Birch Bark, Curcuma Tuber
Shan (50 years old): Dampness stagnation causing abdominal pain, passage of red discharge like bean juice.
Raw Atractylodes Macrocephala Rhizome (3 qian), Stir-fried Hawthorn Fruit (1.5 qian), Magnolia Bark (1 qian), Red Yeast Rice (1.5 qian), Broadleaf Citrus Peel (1 qian), Polyporus (1 qian)
Certain patient: Summer-Autumn dysentery is indeed Damp-Heat injuring Qi, causing Spleen-Stomach Qi stagnation, tenesmus and unsatisfactory passage. The ancient formula Xiang Lian Wan (Aucklandia and Coptis Pill) takes its clearing of interior heat, but must be assisted by Qi-regulating herbs. It is said that when Qi moves, Damp-Heat accumulation has no place to remain. Zhi Mu (Anemarrhena Rhizome) and Sheng Di Huang (Rehmannia Root) nourish Yin and clear heat, treating fire from Yin deficiency and Yang hyperactivity, which is vastly different from Damp-Heat in dysentery. Nourishing leads to stagnation, dulling Qi and causing blockage, explaining why one desires to pass stool but cannot. Ultimately, the Damp-Heat residual pathogen remains. Gui Fu (Cinnamon Twig and Aconite) are hot and drying, again causing anal bearing down and knife-like pain. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is an established method of Dong-Yuan, merely lifting the clear Yang of the Lower Jiao, failing to penetrate directly into the intestines. Using heavy doses of Da Huang (Rhubarb Root) along with Zhi Mu and Sheng Di Huang further injures the Lower Jiao. Texts state that chronic dysentery all belongs to Kidney injury. Lower abdominal pain and bearing down, aversion to cold, clearly indicate Lower Jiao syndrome. Proposing to lift Yang also requires treating from below.
Ginseng Radix et Rhizoma, Poria, Alisma Rhizome, Honey-fried Licorice Root, Saposhnikovia Root, Notopterygium Rhizome, Saussurea Root, Asarum, Fresh Ginger, Jujube
Certain patient: White tongue, thirst but no desire to drink, heat in heart and abdomen, pain with every dysenteric episode, anal bearing down, unsatisfactory passage, slight vomiting with phlegm, altered taste, hollow headache, red cheeks. This is steam from water and grain transforming into Damp-Heat, stagnating in the stomach and intestines, mixing clear and turbid. Suddenly adding irritability and difficulty crying out. The method should be bitter-cold to drain heat, bitter-pungent-aromatic to circulate Qi and permeate-drain dampness. Accumulation is tangible, while Dampness and Heat are inherently intangible.
Coptis Rhizome, Scutellaria Root, Curcuma Tuber, Magnolia Bark, Polyporus, Buckwheat Flower Bud, Birch Bark
Bao: Initial cold limbs (Jue), followed by dysentery with pus and blood, abdominal pain, nausea/vomiting. This is mutual injury of Cold and Heat. (Pattern: Jueyin Latent Heat)
Scutellaria Root (light), Coptis Rhizome, Moutan Cortex, Raw White Peony, Roasted Ginger, Stir-fried Honeysuckle Flower
Chen (Female): Warm pathogen unresolved for ten days, fever with spontaneous diarrhea, consciousness occasionally unclear. This pathogen is latent in Jueyin, fearing transformation into spasm.
Pulsatilla Root, Coptis Rhizome, Scutellaria Root, Northern Birch Bark, Phellodendron Bark, Raw White Peony Root
Second visit: Warm pathogen treated incorrectly with exterior-releasing herbs, seizing fluids. Coma, fearing transformation into spasm/cold limbs.
Stir-fried Rehmannia Root, Donkey-hide Gelatin, Stir-fried Ophiopogon Tuber, Raw White Peony Root, Stir-fried Moutan Cortex, Privet Fruit
Qiu (Elderly woman): Administered moistening agents, pain eased, discharge decreased. Knowing Jueyin dysentery requires softening and unblocking. Blood deficiency with Wind is evident.
Rehmannia Root, Donkey-hide Gelatin, Moutan Cortex, Raw White Peony Root, Honeysuckle Flower, Black Soybean Skin
Certain patient: Heat gradually entering the interior, chest fullness and loose stools. Propose sour-bitter to drain heat.
Scutellaria Root, Coptis Rhizome, Immature Bitter Orange, White Peony Root, Broadleaf Citrus Peel White, Talcum, Licorice Root, Grain Sprout
Cai: Interior deficiency with pathogen sinking,協熱 (Xie Re - accompanying heat) spontaneous diarrhea. Pulse small on left, large on right. Disease persists for nine days without reduction, indicating a severe case. Propose Bai Tou Weng Tang (Pulsatilla Decoction) formula, adding Scutellaria Root and White Peony Root. (Pattern: Accompanying Heat Dysentery)
Pan: Seasonal Summerheat-Dampness enters via mouth and nose. Qi stagnation causes Ying and Wei to lose transport. Must present with fever and no sweat. The pathogen moves from upper to middle, following the Mu Yuan (Sea of Origin), causing gastrointestinal stagnation. Abdominal pain and dysenteric discharge are all transformations of Damp-Heat. Dispersing and eliminating with diuresis is appropriate. If exterior-releasing herbs are used, Yang Qi will be injured.
Poria, Tangerine Peel, Magnolia Bark, Aucklandia Root, Stir-fried Lablab Bean, Stir-fried Hawthorn Fruit
Second visit: Accompanying heat dysentery with sticky bloody water is a transformation of Damp-Heat in the stomach and intestines.
Northern Birch Bark, Pulsatilla Root, Poria, Alisma Rhizome, Stir-fried Honeysuckle Flower, Yi Yuan San (Benefit Element Powder)
Certain patient: Spring-Warmth sinking internally causing dysentery, most prone to collapse (Jue/Tuo).
Coptis Rhizome, Donkey-hide Gelatin, Scutellaria Root (light), Stir-fried Rehmannia Root, Raw White Peony Root, Honey-fried Licorice Root
Wang: Heat toxin lingering and not transforming, tidal fever with dysentery.
Coptis Rhizome, Scutellaria Root, Stir-fried White Peony Root, Poria, Alisma Rhizome, Quince Fruit
Zhang (33 years old): Jiangnan soil is thin, Qi is weak. Summer food accumulation internally, seasonal heat forcing internal gathering. Damp-Heat red dysentery, unresolved into winter, all due to failure to observe dietary restrictions. Should consume bland flavors. (Pattern: Bloody Dysentery)
Raw Atractylodes Macrocephala Rhizome, Magnolia Bark, Southern Hawthorn Fruit, Areca Seed, Melia Root Bark, Sophora Flower, Broadleaf Citrus Peel, Honeysuckle Flower
Second visit: Bloody dysentery for three months, daytime dysentery stopping at night, anus feels like bearing down. Due to Qi sinking, the gate fails to contain.
Ginseng Radix et Rhizoma, Angelica Sinensis, White Peony Root, Cinnamon Twig, Honey-fried Licorice Root, Atractylodes Macrocephala Rhizome, Broadleaf Citrus Peel, Roasted Ginger, Southern Jujube
Certain patient (24 years old): Bloody dysentery for half a year, lower abdominal pain. Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) plus stir-fried Hawthorn Fruit and stir-fried Corydalis Rhizome.
Certain patient: Bloody accumulation painful dysentery, starting in midsummer, persisting until mid-autumn. Clearly Damp-Heat stagnating in stomach and intestines. Prolonged course, complexion fades, right pulse is large and forceful, which is a major taboo in dysentery. Slightly unblock accumulation, simultaneously harmonize blood.
Wine-stir-fried Rhubarb Root, Coptis Rhizome, Scutellaria Root, Moutan Cortex, Cinnamon Twig, Angelica Sinensis Body, White Peony Root, Raw Licorice Root
Yuan (27 years old): Chronic dysentery, abdominal pain, bloody stool.
Raw Astragalus Membranaceus (3 qian), Raw Atractylodes Macrocephala Rhizome (3 qian), Stir-fried Angelica Sinensis Body (1 qian), Stir-fried Hawthorn Fruit (2 qian), Stir-fried Sanguisorba Root (1.5 qian), Broadleaf Citrus Peel (1 qian), Magnolia Bark (1 qian), Notopterygium Rhizome (5 fen), Saposhnikovia Root (5 fen)
Zhu (39 years old): Dysentery with clotted blood, Qi bearing down in anus, no abdominal pain.
Stir-fried Black Melia Root Bark (1 liang), Raw Atractylodes Macrocephala Rhizome (1 qian), Raw Phellodendron Bark (1 qian), Stir-fried Black Hawthorn Fruit (3 qian), Stir-fried Black Sanguisorba Root (1.5 qian), Stir-fried Charred Honeysuckle Flower (1.5 qian), Red Poria (3 qian), Polyporus (1.5 qian)
Certain patient: Painful dysentery unsatisfactory, already passing blood. Summer-Dampness is not only in the Qi level, and due to overwork and vegetarian diet, attacking/purging should be cautious.
Angelica Sinensis, White Peony Root, Southern Hawthorn Fruit, Magnolia Bark, Areca Seed, Roasted Ginger
Certain patient: Slow pulse, pain above umbilicus, loose stool, short urine. This is Dampness stagnating Spleen-Stomach Yang, causing Qi stagnation and tenesmus. Follow the ancients' intent of guiding dampness and dispersing differentiation. (Pattern: Yang Deficiency with Qi Stagnation)
Raw Atractylodes Macrocephala Rhizome, Broadleaf Citrus Peel, Magnolia Bark, Official Cinnamon, Calcined Talcum, Poria, Polyporus, Alisma Rhizome, Stir-fried Hawthorn Fruit
Zhang (57 years old): Deep-hidden pulse, chronic dysentery with abdominal pain, aversion to cold, poor appetite, weak Qi and intestinal stagnation. Use warming and unblocking methods.
Prepared Aconite Carapax, Raw Atractylodes Macrocephala Rhizome, Raw Rhubarb Root, Poria, Magnolia Bark, Aucklandia Root
Second visit: Warming and purging combined, intestinal stagnation not unblocked, all due to weak Fu Yang. Ancient sages treating dysentery do not leave the two methods of unblocking and astringing.
Angelica Sinensis, Cinnamon Heart, Poria, Magnolia Bark, Southern Hawthorn Fruit, Raw Malt
Wang (62 years old): Usually combines warming and tonifying, indicating a Yang-insufficient constitution. Heard of dysentery for two months, did not restrict diet, causing Spleen-Stomach stagnation and obstruction. Now added nausea/vomiting. The Six Fu organs should be unblocked. The method for treating dysentery is either unblocking or astringing. Rectal/intestinal knotting, in Yang deficiency, use warming herbs to unblock.
Prepared Aconite Carapax, Processed Rhubarb Root, Magnolia Bark, Aucklandia Root, Poria Cocos Skin
Fan (27 years old): Dysentery is called "Zhi Xia" (Obstructive Downward Flow), meaning obstruction must cause pain before passage. Moreover, the disease started from careless eating/drinking, Yang Qi is blocked, accumulation stays. Reviewing previous prescriptions, those promoting unblocking were effective, those retaining tonification made the disease worse. All Six Fu organs use unblocking as their function.
Aconite, Rhubarb Root, Poria, Magnolia Bark, Raw Areca Seed, Broadleaf Citrus Peel
Second visit: Warming and purging already effective, residual stagnation in stomach and intestines, all because Yang does not govern transportation. Again assist with Qi-regulating herbs.
Aconite, Processed Rhubarb Root, Poria, Broadleaf Citrus Peel, Magnolia Bark, Raw Alpinia Oxyphylla Fruit, Aucklandia Root, Polyporus
Li: Dysentery approaching two months, slightly yellow eyes, white tongue, dry mouth, dry red lips, abdominal fullness, soft on pressure. Urine不通 (not flowing) all day. Patient describes anal blockage, straining endlessly, only able to expel drops of sticky accumulation. If there were loose stool, it would surely pour out intestinally and be abundant. Thinking of Summer-Autumn, Summer-Dampness attaches internally causing dysentery. Xuanti (Yellow Emperor) calls it "Zhi Xia", meaning stagnating Qi and Blood, not just food stagnation as one cause. All Six Fu organs belong to Yang, using unblocking as function; all Five Zang organs belong to Yin, storing as substance. First diarrhea then dysentery, Spleen transmitting to Kidney is reverse, i.e., Earth overcoming Water. However, one must investigate the reason for this transmission/overcoming. It is latent pathogen filth not cleared from the middle, thus pouring downward. Protracted duration, righteous Qi becomes deficient due to deficiency. Zhongjing discussed the Three Yin, in the Taiyin chapter, first mentioned abdominal fullness. Spleen is a soft organ, only rigid herbs can diffuse Yang and drive out turbidity. But now the two intestines are blocked, Qi does not circulate. Li Zhong Tang (Regulate the Middle Decoction) methods will hardly unblock the Fu organs. Examining Neijing: treat the excess when there are two deficiencies and one excess, opening one side. However, must warm Yang, assist with guiding Qi and driving out stagnation. To attempt turning the mechanism, there is no other way.
Prepared Aconite, Raw Magnolia Bark, Aucklandia Root, Processed Rhubarb Root, Stir-fried Black Star Anise
Second visit: Lethargy for half a month, Spleen and Kidney exhausted again. Spleen failure does not govern healthy transportation, ingested food turns to phlegm foam. Kidney true essence loses control of receiving Qi, fluid water floats up blocking the throat. All are dysentery injuring turbid obstruction, transforming into distension late transmission. Pulse appears wiry and forceful, indicating no Stomach Qi. Minor recovery turning into disease is most inappropriate. Entering winter is the command for storing Yang. Now Yang gradually dissipates, while Yin fluids are withered. Thirst with little drinking, drinking does not quench thirst. Treating Yang must use rigid herbs, making Yin even more depleted. Turning around, no help can be borrowed. Reluctantly differentiate and regulate Spleen and Kidney. Spleen Yang moving hopes for transportation, Kidney Yang still hoping for storage. King's Way is indeed hard to achieve quick success. Considering substance and function, dangerous herbs should not be used.
Morning: Stir-fried Shen Qi Wan (Kidney Qi Pill). Noon: Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) plus Alpinia Oxyphylla Fruit.
Xu (33 years old): Labor fatigue, coughing, blood loss, still not avoiding cold and heat. Food causes diarrhea and dysentery in abdomen. Disease upon disease, recent infection. Method should treat first, distinguishing new and old diseases. (Pattern: Yang Deficiency)
Magnolia Bark, Alpinia Oxyphylla Fruit, Broadleaf Citrus Peel, Poria Cocos Skin, White Peony Root, Honey-fried Licorice Root, Quince Fruit, Stir-fried Lablab Bean
Second visit: Coughing and dysentery, drug treatments contradict. Treating Lung hinders Spleen, treating Spleen hinders Lung. Now entering winter, treating dysentery is key. Patient says morning meal is comfortable, evening meal causes fullness. Spleen-Stomach Yang Qi is lacking. Do not merely use stagnation-resolving and cold-suppressing methods.
White Peony Root (mixed with Cinnamon Wine), Alpinia Oxyphylla Fruit, Broadleaf Citrus Peel, Poria, Scorched Atractylodes Macrocephala Rhizome, Honey-fried Licorice Root, Grain Sprout, Amomum Villosum Shell
Zhang: After dysentery and diarrhea, pulse right is wiry and large. Stomach deficiency, poor intake. Yang weak, unable to govern transportation. Method should unblock Fu Yang.
Ginseng Radix et Rhizoma, Alpinia Oxyphylla Fruit, Stir-fried Cuscuta Seed Cake, Stir-fried Amomum Villosum Seed Powder, Poria, Broadleaf Citrus Peel White
Lu (26 years old): Abdominal fullness, spontaneous dysentery, pulse soft and small. Disease in Taiyin. Moreover, clear and long urination, not comparable to Fu organ Damp-Heat. Method should warm.
Raw Atractylodes Macrocephala Rhizome, Aconite, Poria, Magnolia Bark, Dried Ginger
Xu (24 years old): Dysentery for one year, already edema and difficult urination. Ancient texts say chronic dysentery must injure Kidney. Last month used Li Yin Jian (Regulate Yin Decoction) without effect. Asked about eating porridge causing acid regurgitation, sallow complexion, soft pulse. Middle Jiao Yang daily exhausts, water-grain dampness not transported. Still use pungent-warm to revive Spleen Yang, assist with separating and draining. Use Wei Ling Tang (Stomach and Poria Decoction), remove Licorice, add Alpinia Oxyphylla Fruit.
Chen: Dysentery accumulation slightly slowed, but various symptoms unchanged. Complexion greenish-dull, four limbs cold. Still in danger. Propose advancing Yi Huang San (Yellow Regulating Powder) method.
Ginseng Radix et Rhizoma, Roasted Alpinia Oxyphylla Fruit, Male Clove, Poria, Broadleaf Citrus Peel, Green Tangerine Peel, Quince Fruit, Stir-fried Winter Rice
Certain patient: Pulse micro and fine, cold limbs, unlimited dysentery. Wu Zhu Yu Tang (Evodia Decoction) can only stop pain, still no food intake. This is Yang failure and Yin turbidity, Fu Qi about to perish. Use Tao Hua Tang (Peach Kernel Decoction).
Red Kaolin, Dried Ginger, White Glutinous Rice
Certain patient: After dysentery, stool is not solid, food not well transported. Color and pulse are both deficiency signs. Clear Yang is lost in the middle, Yin Qi leaks out from below first. First regulate the middle Jiao, then secure Yin.
Ginseng Radix et Rhizoma, Atractylodes Macrocephala Rhizome, Poria, Honey-fried Licorice Root, Broadleaf Citrus Peel, Roasted Ginger, Alpinia Oxyphylla Fruit
Certain patient: Spontaneous diarrhea without thirst belongs to Taiyin. Hiccups come from Stomach having little food intake, Chong Qi rebelling upward, having images of Earth failure. Condition is already critical and severe. Propose Jin Gui Fu Zi Jing Mi Tang (Golden Cabinet Aconite and Rice Decoction).
Ginseng Radix et Rhizoma, Aconite, Dried Ginger, Honey-fried Licorice Root, Glutinous Rice
Certain patient: Vegetarian for years, Earth thin, Qi weak. Added to long dysentery, little food, desire to vomit. Spleen-Stomach Yang is衰竭 (exhausted). From summer to now, half a year not cured. If suddenly swelling occurs, what method to apply?
Ginseng Radix et Rhizoma, Atractylodes Macrocephala Rhizome, Dried Ginger, Roasted Ginger, Clove, Poria
Yuan: Middle and Lower Yang微弱 (weak), vomiting/hiccups and dysentery. Warming middle does not respond. Fear prolonging to collapse. Yang should be unblocked, Yin should be retained. This closes the gate preventing leakage. Spring returns to cold valley, vital energy has grasp. Await Mr. Wang to lead discussion.
Ginseng Radix et Rhizoma, Aconite, Roasted Ginger, Stir-fried Glutinous Rice, Red Kaolin, Raw White Peony Root